Provider Demographics
NPI:1417075110
Name:YU, LUCY WEINOR (ACUPUNCTURE PHYSICIA)
Entity Type:Individual
Prefix:MS
First Name:LUCY
Middle Name:WEINOR
Last Name:YU
Suffix:
Gender:F
Credentials:ACUPUNCTURE PHYSICIA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 YAWL DR
Mailing Address - Street 2:
Mailing Address - City:COCOA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32931-2625
Mailing Address - Country:US
Mailing Address - Phone:321-784-0020
Mailing Address - Fax:
Practice Address - Street 1:44 N BREVARD AVE
Practice Address - Street 2:
Practice Address - City:COCOA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32931-2930
Practice Address - Country:US
Practice Address - Phone:321-783-4773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP90171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC0020Medicare ID - Type UnspecifiedHEALTHCARE PROVIDER